Improvement in bistouries



UNITED STATES PATENT OFFICE.

IMPROVEMENT IN BISTOURIES.

Specification forming part of Letters Patent No. 50,330, dated October 10, 1865.

To all 'whom it may concern.'

Be it known that I, CHARLES C. BROWN, of W'ashington, District of Oolumbia, have invented a new and useful Surgical Instrument for Operating1 in Fistulas, Pipes, Strictured Passages, 85e.; and I do hereby declare that the following isa full, clear, and exact description of the construction and operation of the same, reference being had to the annexed drawings, making a part of this specification, in Which- Figure l is a side view; Fig. 2, a transverse section.

Fig. l: A is au inflexible metallic director, curved at one end, with a handle attached at the other end, having a concealed aperture through the superior surface, and a groove upoll the inferior surface. B is a movable blade attached near the handle of director titted to thegroove on the under side of the director A, the lower side being the cuttingedge ofthe blade, extending from the point to the pivot or hinge, and when the blade is closed in the groove of thedirector the instrument is inserted into the pipe or rectum. The ligature O is made of saddlers sewing-silk or any other suitable material, and before the in'- strument is inserted into the pipe or rectum the liga-ture is inserted and passed through the long aperture, (that extends along the top of the director A,) with its ends above, the ligature G being above, so that when the incision is made bythe curved blade B beneath, the cutting-edge does not come in contact with the ligature to cut or sever it, but the ligature is passed through the pipe or rectum and outside of the anus, and the instrumentis then withdrawn. After the incision has been made the ligature is then left resting ou the lower side of the pipe or rectum and in the incision and tied below, keeping the muscles of the incision separate for a few days, unt-il the inside or interior of the pipe has healed and all its matter and huinors passed oft' through the in cision, when the ligature is untied and withdrawn, and theincision soon closes and heals, as shown at Fig. 3, which exhibits the ligature C, with its outer ends, E and F, pipe Grof the fistula, rectum, or lower gut, H, incision J, anus K, wallorouter edge, L, of the anus and ligature C as looped or tied beneath at M. Thus the operator inserts the closed instrument and ligature into the oritice of fistula G, While an assistant holds the upper and back end, E, of the ligature O. The director A, with its ligature extending beyond the point of the director, is passed into and through the rectum H and downward until the end F ot' ligature O is carried through the anus K and held by the left hand ot' the operator. The ligature C is then above the directorA, and the incision J is made of the size required with out cutting through the wall L ot the anus. The end F ot' the ligature C is then held firmly, and the instrument is then withdrawn, and the two ends E and F are then drawn and tied together at M, which keeps the ligature O restingin the incision J until allabove it is healed, after which the ligature O is withdrawn and the incision J closes and heals.

The back end of the blade B operates on a pivot, andhas a spring at the outer rear end to regulate the cutting operation by the pressure of the fingers of the operator, while the screw D is the gage to limit the extent of the incision required.

Fig. 2: A is a trans\erse section; B, the groove; C, the aperture.

The benefits arising from the instrument are- First. The introduction into the pipe or passage is less painful than the introduction of the unsheathed knife.

Second. It limits the locality and extent of the incision in the passage, stricture, or pipe in which it is used.

Third. It may be used with safety iu cases of lithotomy, stricture of the rectum, andin all other cases Where a concealed incision is desired.

What I claim as my invention, and desire to secure by Letters. Patent, is-

The construction of the director A,provided with a groove for the reception ot' a ligature, C, as and for the purpose herein set forth.

OHAS. O. BROWN, M. I).

Attest:

A. L. WALLAR, D. K. BARRETT. 

